Comparison Of Single-headed Intramedullary Nails And Combined Interlocking Intramedullary Nails In The Treatment Of Seinsheimer Type Ⅴ Subtrochanteric Femur Fractures In Elderly Patients

Objective:To compare the efficacy of single-headed intramedullary nails(third-generation Gamma Long nail,TGLN)and combined interlocking intramedullary nails(INTERTAN)in the treatment of Seinsheimer type V subtrochanteric femur fractures in elderly patients.Methods:A retrospective analysis of 41 elderly Seinsheimer type V subtrochanteric femur fracture patients diagnosed and treated in the Department of Traumatology and Orthopedics of the First Hospital of Jilin University from January 2016 to January 2020 was carried out to compare the therapeutic effects of TGLN internal fixation and INTERTAN internal fixation.41 patients were divided into two groups according to the fixation device: TGLN group(21 cases;11 males,10females),and INTERTAN group(20 cases;9 males and 11 females).Patients were followed up regularly after operation,and the clinical data,intraoperative blood loss,intraoperative operation time,fracture healing,Harris hip score and postoperative complications of the TGLN group and the INTERTAN group were recorded and compared.Result:The postoperative follow-up time span of the patients in this study was 12-24 months,and the average follow-up time was 18 months.The preoperative waiting time and hospital stay of the TGLN group were(25.9±11.3)hours and(7.57±2.60)days,respectively.The average waiting time of the INTERTAN group was(25.6±13.2)hours and(8.05±3.38)days,respectively.The difference between the groups was not statistically significant(P>0.05);the conditions of half incision and temporary fixation(bone clamp or cerclage wire)during the operation of the TGLN and INTERTAN groups were similar(P=0.819),and there was no statistical difference between the two groups The operative time of the TGLN and INTERTAN groups was(55.62±15.49)minutes and(85.90±15.09)minutes,respectively.The difference between the two groups was statistically significant(P<0.001);the intraoperative blood loss of the TGLN and INTERTAN groups were respectively 145(135,160)ml and 257(223,278)ml,the difference between the two groups was statistically significant(P<0.001);the postoperative HHS and fracture healing time of the TGLN and INTERTAN groups were(80.71±4.28,81.10±4.30)There was no statistically significant difference between the two groups in)points and(90.2±5.5,91.5±3.9)days(P>0.05);there was no statistical difference in the overall incidence of complications between the TGLN and INTERTAN groups(P=0.368).in the TGLN group had shorter operation time and less intraoperative blood loss,compared with those in the INTERTAN group(P<.05).There were no signifificant between-group differences in postoperative complications,fracture healing time and Harris Hip Scores during the follow-up(P>.05).Conclusion:Both TGLN and INTERTAN internal fixation have good clinical effects in the treatment of elderly Seinsheimer type V subtrochanteric fractures.The TGLN group was superior to the INTERTAN group in terms of operation time and intraoperative blood loss.There was no significant difference between the two groups in fracture healing time,postoperative complications,postoperative HHS and postoperative functional recovery,but the small sample size affected this intensity of discovery.